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Five Clinicians Give Their Take on What to Do Now

By Chris Lyford - Asha recently gave her therapist a homemade necklace, which he accepted, thinking it innocuous enough. Now, she brings it up almost every session, asking why he's not wearing it and if he still likes it. Asha has a history of attachment issues, and her therapist worries his response might offend her or cause her to quit therapy. Here's how five therapists say they'd respond.

A Therapist's Surprise Connection With Her Client

By Christina Emanuel - Ryan’s reputation arrived before he did: brilliant, oppositional, angry, a general pain in the butt, and autistic. Over the years, he certainly tried my patience and tested my commitment to him. But one day, a few years into his treatment, Ryan noticed a shift in me that helped me redefine what he's capable of, and what we're capable of together.

A Story About Breaking Tradition, and What Happened Afterwards

By Michael Hoyt - We therapists tend to worry a lot about boundaries, sometimes to the point that we forget that sharing our humanity can be a gift, not a distortion. But when is it okay to go with our impulse and when is it wiser to hold back?

A Story of Navigating a Tricky Ethical Issue Creatively

By Lisa Ferentz - Sometimes, clients give us the gifts they want for themselves but don’t feel worthy of receiving. And sometimes, by helping them see the attributes in themselves that they admire in us, we can help them reconnect with those qualities.

Reconciling Boundaries with the Therapeutic Alliance

When I was young and only three years out of graduate school, one of my first private clients came into a session carrying a small package simply wrapped in brown paper and string. The memory of that package and how I reacted to it haunts me still. Inside, was a necklace, and not just any necklace: a gold chain with a diamond pendant that she had designed herself, worth about $500. I told her flatly that accepting something so expensive was against the ethical rules of my profession. Suddenly, I'd allowed other voices into the sanctuary of our therapy. Once they were there, I couldn't get them out.